Provider Demographics
NPI:1275659062
Name:ABUNDANT CARE INC
Entity Type:Organization
Organization Name:ABUNDANT CARE INC
Other - Org Name:ABUNDANT CARE AGENCY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:816-246-5099
Mailing Address - Street 1:202 NW REDWING DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-2145
Mailing Address - Country:US
Mailing Address - Phone:816-246-5099
Mailing Address - Fax:816-246-5099
Practice Address - Street 1:202 NW REDWING DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-2145
Practice Address - Country:US
Practice Address - Phone:816-246-5099
Practice Address - Fax:816-347-8680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization